Provider Demographics
NPI:1184878050
Name:HERSHBERGER, DAWN ELIZABETH (PA-C)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:ELIZABETH
Last Name:HERSHBERGER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2270
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81602-2270
Mailing Address - Country:US
Mailing Address - Phone:970-384-7033
Mailing Address - Fax:970-945-5460
Practice Address - Street 1:1906 BLAKE AVE
Practice Address - Street 2:
Practice Address - City:GLENWOOD SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81601-4227
Practice Address - Country:US
Practice Address - Phone:970-384-6770
Practice Address - Fax:970-384-6765
Is Sole Proprietor?:No
Enumeration Date:2008-11-05
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA-2714363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical